Improving Aging in Place in Subsidized Housing

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

75 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-01-13

Study Completion Date

2023-03-02

Brief Summary

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This pilot study will evaluate the feasibility and preliminary effectiveness of an adapted version of the Function Focused Care intervention, delivered by telephone, for improving aging in place for older adults living in subsidized housing. The study will include participants with and without mild cognitive impairment or mild dementia and will examine whether the study outcomes differ by cognitive status. Findings from this study will provide new information about how to optimize function and physical activity among older adults with and without cognitive impairment living in subsidized housing.

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Detailed Description

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Millions of older adults with low incomes live in federally-subsidized housing and are at disproportionate risk for nursing home admission. Effective approaches are needed to improve aging in place for this vulnerable population. The objective of this study is to pilot test the feasibility and preliminary effectiveness of a telephone-based intervention to improve aging in place for older adults living in subsidized housing. In the first phase of this study, the investigators used methods of implementation science to adapt an existing intervention, Function Focused Care for Assisted Living, to the unique setting of affordable housing. Function Focused Care is a philosophy of care in which assisted living staff members engage residents in functional and physical activity during all care interactions. Prior research supports the effectiveness of Function Focused Care for maintaining function and increasing physical activity among older adults in assisted living settings.

In the first phase of this study, the investigators interviewed subsidized housing stakeholders - including residents, staff members, and caregivers - to identify barriers, facilitators, and needed adaptations to Function Focused Care for Assisted Living. The investigators used the findings from these interviews to adapt the intervention. In this 2-month pilot study, the investigators will use a wait-list control design with site randomization to assess the feasibility and preliminary effectiveness of the adapted intervention. The investigators will recruit individuals with and without mild cognitive impairment or mild dementia and will examine whether the study outcomes differ by cognitive status. The findings from this study will provide new information about how to optimize function and physical activity among older adults with and without cognitive impairment living in subsidized housing.

Conditions

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Physical Disability Cognitive Impairment Physical Activity

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This is a pilot study testing the adapted Function Focused Care intervention. The study employs a wait-list control design and site randomization.

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Immediate Intervention

Upon enrollment, participants receive the adapted telephone-based intervention, the Independent Living Program for Affordable Housing, for two consecutive months.

Group Type EXPERIMENTAL

Independent Living Program for Affordable Housing.

Intervention Type BEHAVIORAL

Two-month program intended to increase physical activity and function, including the following 4 steps:

1. Environmental and Policy Assessments: Nurse facilitator works with the affordable housing staff to identify and recommend feasible interventions to alter the environment, policy, and procedures to optimize resident function and physical activity.
2. Education: Nurse educates residents and study partners in the principles of the Independent Living Program, using established materials and adult learning techniques.
3. Establishing Resident Goals: The nurse completes Capability Assessment Forms and helps resident set goals to increase function and physical activity.
4. The nurse helps to motivate and mentor residents and study partners to achieve and maintain their goals, using evidence-based approaches.

Wait-list Control

Two months after study enrollment, participants receive the adapted telephone-based intervention, the Independent Living Program for Affordable Housing, for two consecutive months.

Group Type EXPERIMENTAL

Independent Living Program for Affordable Housing.

Intervention Type BEHAVIORAL

Two-month program intended to increase physical activity and function, including the following 4 steps:

1. Environmental and Policy Assessments: Nurse facilitator works with the affordable housing staff to identify and recommend feasible interventions to alter the environment, policy, and procedures to optimize resident function and physical activity.
2. Education: Nurse educates residents and study partners in the principles of the Independent Living Program, using established materials and adult learning techniques.
3. Establishing Resident Goals: The nurse completes Capability Assessment Forms and helps resident set goals to increase function and physical activity.
4. The nurse helps to motivate and mentor residents and study partners to achieve and maintain their goals, using evidence-based approaches.

Interventions

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Independent Living Program for Affordable Housing.

Two-month program intended to increase physical activity and function, including the following 4 steps:

1. Environmental and Policy Assessments: Nurse facilitator works with the affordable housing staff to identify and recommend feasible interventions to alter the environment, policy, and procedures to optimize resident function and physical activity.
2. Education: Nurse educates residents and study partners in the principles of the Independent Living Program, using established materials and adult learning techniques.
3. Establishing Resident Goals: The nurse completes Capability Assessment Forms and helps resident set goals to increase function and physical activity.
4. The nurse helps to motivate and mentor residents and study partners to achieve and maintain their goals, using evidence-based approaches.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Lives in an included subsidized housing setting
* 62 years of age or older
* Speaks English or Spanish well or very well
* Able to provide informed consent OR able to provide assent and has a proxy who provides informed consent on his/her behalf
* Has difficulty or needs help in at least 1 ADL and/or IADL OR has mild cognitive impairment or mild dementia based on their Montreal Cognitive Assessment (MoCA) score
* Not enrolled in hospice

* Speaks English or Spanish well or very well
* Able to provide informed consent
* Spends at least an hour per week with the resident

* Speaks English or Spanish well or very well
* Able to provide informed consent

Exclusion Criteria

* Younger than 62 years of age
* Does not speak English or Spanish
* Lacks decision making capacity and lacks a proxy to consent on his/her behalf
* Does not have functional impairment or cognitive impairment
* Has moderate to severe dementia based on his/her MoCA score
* Is enrolled in hospice

* Does not speak English or Spanish
* Unable to provide informed consent
* Does not spend at least an hour per week with the resident

* Does not speak English or Spanish
* Unable to provide informed consent

Minimum Eligible Age

62 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Responsible Party

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Rebecca Brown, M.D. MPH

Faculty - Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Rebecca Brown, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

University of Pennsylvania

Locations

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Northgate 2

Camden, New Jersey, United States

Site Status

Haven House

Cape May, New Jersey, United States

Site Status

Victorian Towers

Cape May, New Jersey, United States

Site Status

Stonegate 1

Pennsauken, New Jersey, United States

Site Status